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Individual

MR. ALAN DEAN FAZEKAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LISW-S

Contact information

Practice address
444 N MAIN ST, STE. 408, AKRON, OH 44310-3110
(330) 379-5005
(330) 379-5562
Mailing address
444 N MAIN ST, STE. 408, AKRON, OH 44310-3110
(330) 379-5005
(330) 379-5562

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.0005369-SUPV
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SW15962
MEDICARE ID
OH
Enumeration date
01/07/2011
Last updated
09/28/2011
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